Overview
- The international systematic review in The Lancet Obstetrics, Gynaecology & Women's Health evaluated 43 studies and found no clinically important association between prenatal paracetamol use and autism, ADHD, or intellectual disability.
- The meta-analysis emphasized low-bias and sibling-comparison designs and pooled large cohorts, including more than 300,000 autism, 400,000 ADHD, and 500,000 intellectual disability records.
- The authors said previously reported links are likely explained by genetic predisposition or maternal factors such as fever or underlying pain rather than a drug effect.
- Major medical bodies and regulators maintain guidance that paracetamol remains the first-line option for pain or fever in pregnancy when used as directed, with experts cautioning that avoiding treatment can increase risks from untreated fever or pain.
- An HHS official criticized the review’s methodology and scope, while the authors acknowledged limits including few sibling studies, heterogeneous exposure and outcome measures, and scarce dose or timing data.